Decompressive lumbar laminectomy removes vertebral bone and ligaments that are compressing the spinal cord or nerve

root. Removing this bone and tissue opens up the area and gives the nerve roots more space and therefore relieve symptoms related to compression and irritation of the spinal cord or nerve root(s). Laminectomy removes all of the lamina on selected vertebrae. Decompressive lumbar laminectomy is generally done when symptoms of lumbar spinal stenosis become severe. The surgery involves several steps: General anesthesia is administered. A 2- to 5-inch incision is made in the back. The surgeon first removes one or more of the spinous processes, which are the bumps you feel as you run your hand up your back. The surgeon then removes the lamina from the vertebraehence the term "laminectomy," or lamina removal. The laminae, which cover the nerve roots and spinal cord, form the roof of the spinal canal. The laminae also give support and protection to the spinal cord. Other small joints, called facet joints, may be trimmed. Any bone fragments are removed. If herniated disc tissue is also impinging on the nerve root, that disc tissue (but not the entire disc) is removed.

Pre Nurse Care: See if there are any questions or concerns about surgery; make sure consent form is signed; explain risks associated with surgey; fill out all paperwork; stop taking NSAIDs and any bloodthinners one week before surgery; stop smoking, chewing tobacco, and drinking alcohol one week before and 2 weeks after surgery as these activities can cause bleeding problems; Patients are admitted to the hospital the morning of the procedure. No food or drink is permitted past midnight the night before surgery. An intravenous (IV) line is placed in your arm. An anesthesiologist will explain the effects of anesthesia and its risks. Post Nurse care: Discomfort After surgery, pain is managed with narcotic medication. Because narcotic pain pills are addictive, they are used for a limited period (4 to 8 weeks). Restrictions If you have had a fusion, do not use non-steroidal anti-inflammatory drugs (NSAIDs) (e.g., aspirin; ibuprofen, Advil, Motrin, Nuprin; naproxen sodium, Aleve) for six months after surgery. NSAIDs may cause bleeding and interfere with bone healing. Do not drive for 2 to 4 weeks after surgery or until discussed with your surgeon. Avoid sitting for long periods of time. Do not lift anything heavier than 10 pounds (e.g., gallon of milk). Do not bend or twist at the waist. Housework and yard-work are not permitted until the first follow-up office visit. This includes gardening, mowing, vacuuming, ironing, and loading/unloading the dishwasher, washer, or dryer. Postpone sexual activity until your follow-up appointment unless your surgeon specifies otherwise. Do not smoke. Smoking delays healing by increasing the risk of complications (e.g., infection) and inhibits the bones' ability to fuse. Activity

 You may need help with daily activities (e.g., dressing, bathing) for the first few weeks. Fatigue is common. Let pain be your guide. Gradually return to your normal activities. Walking is encouraged; start with a short distance and gradually increase to 1 to 2 miles daily. A physical therapy program may be recommended. If applicable, know how to wear the brace before you leave the hospital. Wear for daily activities (excluding sleep) unless instructed otherwise. Bathing/Incision Care You may shower 4 days after surgery unless instructed otherwise. Staples or stitches, which remain in place when you go home, will need to be removed. Ask your surgeon or call the office to find out when. When to Call Your Doctor If your temperature exceeds 101 F or if the incision begins to separate or show signs of infection, such as redness, swelling, pain, or drainage.